Psychosocial management of depression

Abstract

The treatment of depression in older people has to include consideration of psychosocial factors. Evidence for the efficacy of psychological therapies for depression in elderly out-patients is reviewed. To date CBT and brief psychodynamic therapies seem to be equally effective. Issues of loss are often associated with depression in later life, and grief therapy may be indicated in certain circumstances. The relationship of physical health and depression is a complex one, which needs to be addressed carefully and sensitively in therapy. Family therapy and group approaches are beginning to be used more often and psychosocial alternatives to benzodiazepines as anxiolytics and hypnotics are being developed. Therapists need to be aware of the personal issues raised by working with older people, and to be more flexible and accommodating in a variety of ways than may be necessary with many younger people